New Combined Spasm Provocation Test in Patients With Rest Angina : Intracoronary Injection of Acetylcholine After Intracoronary Administration of Ergonovine
スポンサーリンク
概要
- 論文の詳細を見る
The incidence of provoked coronary spasm with the standard single spasm provocation test has been relatively low in patients with rest angina. The present study examined the clinical usefulness of a newly designed spasm provocation test, an intracoronary injection of acetylcholine (ACh) following an ergonovine (ER) test, in patients with rest angina who demonstrated low disease activity and atypical chest pain. Triple sequential spasm provocation tests were preformed in 24 patients with atypical chest pain who had no ischemia and in 40 patients with rest angina who had distinct ischemia. Initially, an ACh test (20-100μg) and then an ER test (40-64μg) were performed and then, if no spasm was provoked, an intracoronary injection of ACh was given after the ER test to evaluate coronary spasm. Coronary spasm was defined as total or subtotal occlusion. In the 24 patients with atypical chest pain, no spasm was provoked by intracoronary injection of either ACh or ER, but coronary spasms were induced in 2 patients using the new method, with the remaining 22 not experiencing spasm (specificity of new method, 92%). In the 40 patients with rest angina, intracoronary injection of ACh induced coronary spasm in 22 patients (group I) and 6 (group II) demonstrated spasm with intracoronary injection of ER. Coronary spasm was not induced by either the ACh test or the ER test in 12 patients (group III). The intracoronary administration of ACh after the ER test provoked spasm in 11 of 12 patients. Diffuse spasms were provoked in 10 of 11 patients. In patients with rest angina, the frequency of chest pain attacks in 1 month experienced by patients in group III (0.8±0.8) was significantly lower than that of patients in group I (7.0±5.3, p<0.01) or II (3.5±2.3, p<0.05). No serious or irreversible complications related to this new combined method were observed. In conclusion, this method was safe and reliable for the induction of coronary spasm in patients with rest angina who may have low disease activity.
- 社団法人日本循環器学会の論文
- 2000-07-20
著者
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Ochi Naoto
Department of Cardiology, Kita Medical Association Hospital
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Kawada Hiroyuki
Department of Cardiology, Kita Medical Association Hospital
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Uraoka Tadao
Department of Cardiology, Kita Medical Association Hospital
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Mineoi Kazuaki
Department of Cardiology, Takanoko Hospital
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Kondou Tadashi
Department of Cardiology, Takanoko Hospital
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Yano Kazuo
Department of Cardiology, Takanoko Hospital
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Ochi Takaaki
Department Of Cardiology Takanoko Hospital
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Sueda Shozo
Takanoko Hospital
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Ochi Takaaki
Takanoko Hospital
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Yano Kazuo
Takanoko Hospital
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Mineoi Kazuaki
Takanoko Hospital
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Kondou Tadashi
Takanoko Hospital
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Ochi Naoto
Uwajima Social Insurance Hospital
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Hayashi Yutaka
Uwajima Social Insurance Hospital
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Kukita Hitoshi
Uwajima Social Insurance Hospital
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Matsuda Shouzou
Kita Medical Association Hospital
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Kawada Hiroyuki
Kita Medical Association Hospital
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Tsuruoka Takashi
Takanoko Hospital
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Uraoka Tadao
Kita Medical Association Hospital
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Ochi Naoto
Department Of Cardiology Kita Medical Association Hospital
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Uraoka Tadao
Department Of Cardiology Kita Medical Association Hospital
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Mineoi Kazuaki
Department Of Cardiology Takanoko Hospital
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Ochi Takaaki
The Second Department Of Internal Medicine Ehime University School Of Medicine
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Tsuruoka Takashi
Department Of Internal Medicine Ehime Prefectural Minamiuwa Hospital
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Kawada Hiroyuki
Department Of Cardiology Kita Medical Association Hospital
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